Int. J. Life. Sci. Scienti. Res.

, 2(5): 619-622

(ISSN: 2455-1716)

Impact Factor 2.4

SEPTEMBER-2016

Research Article (Open access)

Morphological Study of the Menisci of the Knee

Joint in Adult Cadavers of North Indian
Population
Dr. M Yousuf Sarwar1*, Dr. Nilesh Kumar2, Dr. Tarannum Yasmin3
Associate Professor, Department of Anatomy, Katihar Medical College Katihar, Bihar, India
2
Assistant Professor, Department of Anatomy, Katihar Medical College Katihar, Bihar, India
3
Associate Professor, Department of Microbiology, Katihar Medical College Katihar, Bihar, India
1

Address for Correspondence: Dr. M Yousuf Sarwar, Associate Professor, Department of Anatomy, Katihar Medical
College Katihar, Bihar, India
Received: 15 July 2016/Revised: 13 August 2016/Accepted: 28 August 2016

ABSTRACT- INTRODUCTION- The Menisci are semi-lunar crescent shaped fibro-cartilages which serve to widen
and deepen the articulation of tibial surfaces that receive the femur condyles forming the knee joint.
OBJECTIVE- To assess the incidence of different shapes of the medial and lateral meniscus and the incidence of discoid
meniscus in the North Indian population.
METHODS- The study included 112 menisci from 56 adult cadavers knee joint irrespective of sex that were preserved in
10% formalin. After methodical dissection procedure the morphological variants of the shape of menisci were
macroscopically noted and classified. The medial menisci were sub-grouped as crescent-shaped, V- shaped, U- shaped,
C- shaped and sickle shaped. Lateral menisci were sub-grouped as crescent-shaped, C- shaped and discoid-shaped.
RESULTS AND CONCLUSIONS- In the present study, 80% of the medial menisci were crescent shaped, 12.8% were
V-shaped while 7.2% sickle-shaped. Among the lateral menisci, maximum number of specimen were C-shaped i.e. 78%
followed by crescent shaped in 19% and discoid shaped in 3% specimen. Knowledge of various shapes of meniscii would
be useful for health professionals who treat athletes with suspected meniscal tear.
Key-words- Knee, Lateral meniscus, Medial meniscus, Shape, Discoid
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INTRODUCTION

The Menisci of the knee joint are to be considered main

elements for perfect articulation among the articular
osseous surfaces. Menisci are semicircular shaped fibro
cartilagenous structures with bony attachments at the
anterior and posterior aspect of tibial plateau and are
wedged between femoral condyles and tibial plateau, the
medial and lateral sides of the knee joint. [1] It is a double
condyloid joint with 20 degree of freedom of motion. The
functions of menisci include shock absorption, load
transmission and improve joint stability pro-prioception,
joint lubrication and nutrition. [2]
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DOI:
10.21276/ijlssr.2016.2.5.19

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The anatomical abnormalities and variation of the

intra-articular structures of knee joint have recently gain
importance because of new techniques such as arthoscopy,
computed tomography and magnetic resonance imaging
investigation of these variants are important in order to
define the morphological features for surgical procedures
and clinical diagnosis. [3] The menisci have several roles
that contribute to the successful function of the knee.
Injuries to the meniscus are common in activities and
sports. Long term complication of removal of a meniscus
includes cartilage degeneration and bone remodeling. [4]
Hence, today a ruptured meniscus is repaired rather than
removed, but this treatment is only feasible when the
meniscus is of good quality. [5] Hence, this study was
undertaken with the objective to estimate the incidence of
different shapes of medial and lateral meniscus and also the
incidence of discoid meniscus in North Indian population.

MATERIALS AND METHODS

The study was conducted over a period of two years in the

department of Anatomy, Katihar Medical College Katihar,
Bihar, India. For this study, human adult knee joint

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available in the anatomy laboratory were used. The study

included 112 menisci from 56 knee joints of the North
Indian population. All specimens preserved in a solution of
10% formalin were used. Menisci which showed any
structural change due to injuries or advanced degenerative
changes were excluded as that may prevent its
morphological analysis. After the dissection of skin and
muscles, the approaches to the menisci were performed,
opening anteriorly by a longitudinal incision on each side
of the joint capsule, cutting the patellar ligament and the
collateral ligaments transversely to expose the menisci
clearly, the joint capsule and the intra-articular ligaments
were cut and the condyles were circumferentially detached
from their soft tissue attachments and removed, exposing
the tibial plateau. The dissection procedures were
performed in a systematic fashion and the data were
recorded on a standardized collection sheet.
Morphological variants of the shapes of the meniscus were
macroscopically noted and classified. The medial meniscus
(MM) was sub-grouped as crescent shaped, U-shaped,
V-shaped, C-shaped and sickle shaped. The lateral
meniscus (LM) was sub-grouped as crescent (semilunar)
shaped, C-shaped and discoid shaped. When the meniscus
covers the tibial plateau circularly the meniscus is said to
be discoid. The incomplete discoid menisci had an opened
area at the centre of menisci and they were horse shoe
shaped. The menisci which did not have any opened area at
the centre of the menisci were defined as complete discoid
menisci.
Menisci which had the anterior and posterior horns and a
thin body were defined as crescent (semilunar) type. The
meniscus which had thin anterior and posterior horns and a
thick body were defined as sickle shaped type.

RESULTS

Table: 2 Showing the incidence of different shapes of

lateral meniscus (n=56)
Shape

Total & Percentage (%)

C shaped

44 (78%)

Crescentic

10 (19%)

Discoid

02 (3%)

Fig 1: Right tibial plateau showing C-shaped lateral

meniscus

Study was done on 112 menisci. It was observed that

80%of medial menisci were crescent shaped, 12.8%
showed V-shaped and 7.2% were sickle shaped. Among the
lateral menisci 78% were C-shaped, 19% were crescent
shaped and 3% showed incomplete discoid.

Table: 1 Showing the incidence of different shapes of

medial meniscus (n=56)
Shape

Total & Percentage (%)

Crescentic

45 (80%)

Sided V

07 (12.8%)

Sickle shaped

04 (7.2%)

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Fig 2: Incomplete discoid lateral meniscus of left

knee joint

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Fig 3: Left tibial plateau showing cresent shaped

medial meniscus

DISCUSSION

The differences of the shape of meniscus may be due to the

mesenchymal differentiation or to the development of the
vasculature early in embryonic life. Variations of
morphological differences of menisci can determine the
possibility of an injury. There are marked differences in the
contour and insertion between the lateral and medial
meniscus which are important in relation to the injury
mechanisms. Anomalies of the meniscal shape have been
reported in man and are classified as hypoplasia or
hyperplasia. The meniscal hyperplasia or discoid menisci
have been the object of many studies among because they
are frequently the source of symptoms.
In primates, Parsons noted that medial meniscus (MM)
always has a crescentic shape but the lateral meniscus (LM)
may have either a crescent or disc shape. Vallois [6]
confirmed the observation and studied the whole
morphology of the knee joint in primates.
Flick & Rudolph [7] described the medial meniscus (MM)
as a half, two third or three-fourth ellipse and stated that the
lateral could be compared to an almost complete circle. In
contrast, Charles [8] classified the menisci, both on the basis
of the relative size of the anterior and posterior cornua and
also on the degree of curvature. In 1889, Young [9]
described a discoid lateral meniscus in a cadaver specimen.
Discoid meniscus is an atavistic anomaly in which the
meniscus of the knee, predominantly LM, is discoid rather
than semilunar in shape. [10] The fact was mentioned as the
discoid meniscus was most likely a congenital deviation
and usually occurred laterally. Moreover it was reported
that the discoid shape resulted in a greater coverage of the
tibia and was usually associated with increased thickness of
the meniscus that might lead to abnormal shearing forces
across the knee joint [11].
The most common congenital abnormality of the meniscus
in man is a discoid meniscus with a reported incidence of
0.4 to 17%, the vast majority occurring on the lateral side
of the knee. [12] From a study conducted by Rao and Rao [13]
in south India based on 3167 knee arthroscopies done
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between the years 1993 and 2004, 177 (5.59%) discoid

lateral menisci were encountered. The present study
reported the incidence of discoid meniscus 3% from the
North Indian population. Our result that in majority of
specimen (80%), the medial meniscus (MM) was crescent
shaped and the most common shape of lateral meniscus
(LM) was C-shaped (78%). The study has provided
information on different shapes of lateral and medial
meniscus with contribution to a better delineation of
meniscal anatomy.

CONCLUSION
From our study we can conclude that in most of the
specimen the medial meniscus was crescentic in shaped
(80%). Commonest incidence of lateral meniscus was
C-Shaped (78%). Incomplete lateral discoid menisci were
observed in 3% of lateral meniscus. Our study will provide
support to the meniscal anatomy concerning the surgical
procedures and of the knee joint. The study has provided
further information on different shapes of the medial and
lateral meniscus especially the presence of incomplete
lateral discoid menisci in adults which is a more important
finding. This study is useful for the health professional who
work with the treatment of meniscal injuries to create an
awareness of the anatomical variation that exist in the
menisci facilitating the rehabilitation process.

ACKNOWLEDGMENT

We thank to Prof N. K. Pandey and all the staff of

department of Anatomy KMC Katihar for their invaluable
advice and support. The authors are grateful to authors/
editos/ publishers of all those articles, journals and books
from where the literature of this article has been reviewed
and discussed.

REFERENCES

[1] Buckwalter JA, Amendolam A, Clark CR. Articular cartilage

and meniscus. In: Insall and Scott NW. Surgery of the knee.
1st ed. London: Churchill Livingstone; 1986.p.310.
[2] Gray JC. Neural and vascular anatomy of the menisci of the
human knee. J Orthop Sports Phys Ther. 1999; 29 (1):
23-30.
[3] Moore KL, Dalley AF. Clinically oriented anatomy. 4th ed.
Philadelphia: Lippincott Williams and Wilkins; 1999. P
690-99.
[4] Fairbank TJ. Knee joint changes after meniscectomy.
Journal of Bone and Joint Surgery 1948; 30B:664-70.
[5] Messner K, Gao J. The menisci of the knee joint: Anatomical
and functional characteristics and a rationale for clinical
treatment. J Anat 1998; 193: 161-78.
[6] Vallois H. Etude Anatomique de, Articulation du Genou
chez les Primates. Montpellier: Labeille. 1914
[7] Fick & Rudolph. In: Bardelebens Handbuch der Anatomie
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Mechanik der Gelenke, Teil I und III, S. G. Fischer, Jena.
1904; 354-358.
[8] Charles CM. On the menisci of the knee joint in American
Whites and Negroes. Anat Rec 1935; 63:355-364.

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[9] Young R. The external semilunar cartilage as a complete

disc. In: Cleland J, Young R, eds. Memoris and Memoranda
in Anatomy. London: Williams and Norgate, 1889; 179.
[10] Parson HG. The external semilunar cartilage of the knee in
the primates. J Anat 1900; 34:32.
[11] Kelly BT, Green DW. Discoid lateral meniscus in children.
Curr Opin Pediatr 2002; 14: 54-61.
[12] Dickhaut SC, DeeLee JC. The discoid lateral meniscus
syndrome. J Bone Joint Surg Am 1982; 64: 1068-1073.
[13] Rao SK, Rao PS. Clinical, radiologic and arthroscopic
assessment and treatment of bilateral discoid lateral
meniscus. Knee Surg Sports Traumatol Arthrosc 2007; 15:
597-601.
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